| NPI | 1750502670 |
|---|---|
| Other Name | GREGORY CARL KENNON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 2707) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2007-07-08 |